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Shengma (Rhizoma Cimicifugae), with a bitter and sweet taste, and a neutral to slightly cold nature, has a floating and ascending property, belonging to Yang. It is non-toxic. It enters the Foot-Yangming Stomach Meridian and the Foot-Taiyin Spleen Meridian. It can ascend the Qi of the Spleen and Stomach. When used together with Baizhi (Radix Angelicae Dahuricae) and Congbai (Stem and Bulb of Allium fistulosum), it also enters the Hand-Yangming Large Intestine Meridian and the Hand-Taiyin Lung Meridian; it does not enter other meridians. It can ward off epidemic pathogens, disperse pathogenic heat in the skin and muscles, relieve pain in the head, teeth, and throat, treat Zhong'e (sudden illness caused by foul and turbid pathogens), resolve macules and rashes, and indeed achieve remarkable results. It is effective for treating Fei Yong (Lung Abscess), but must be used jointly with Qi- and Blood-nourishing herbs. It can serve as an assistant or guide herb, but should not be used as a sovereign or minister herb. People worry that it disperses Qi and dare not use it in large doses, which is correct; however, there are times when it is appropriate to use it in larger doses. Materia Medica texts such as *Bencao Gangmu* (Compendium of Materia Medica) and *Jingshu* (Elucidation of the Classics) have not yet mentioned this, let alone other books.

The condition where Shengma can be used in larger doses refers to the disease of Fa Ban (eruption of macules/rashes). Whenever the heat is not severe enough, Fa Ban will certainly not occur; only when the internal heat is extremely severe does it manifest outwardly. Because the skin and hair follicles are tight, the heat cannot emerge rapidly, resulting in macules that cannot dissipate suddenly. Shengma is originally not a herb for resolving macules; to resolve them, one must clear the internal heat. Herbs for clearing heat include Yuan Shen (Radix Scrophulariae), Maidong (Tuber of Ophiopogon), Huang Qin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis), and Zhi Zi (Fructus Gardeniae). However, Yuan Shen, Maidong, Huang Qin, Huang Lian, and Zhi Zi have a descending action and cannot move outward; they must rely on Shengma to guide these herbs to the skin and hair follicles, so that the macules may completely disappear. If Shengma is used in small doses, it cannot guide the medicinal action outward, and the heat will inevitably move inward, concentrating entirely in the Large Intestine and Small Intestine. The nature of Fire is to flare upwards; guiding it upward makes it easier to dissipate, while allowing it to descend makes it difficult to resolve. This is why Shengma must be used in larger doses, allowing the toxic heat to be thoroughly digested and cleared along with Yuan Shen, Maidong, Huang Qin, Huang Lian, and Zhi Zi. (Comment: The elucidation of principles is very profound.)

Generally, when Yuan Shen and Maidong are used in doses of 1 to 2 liang, Shengma can be used in larger doses up to 5 qian; the minimum should be 4 qian or 3 qian. It is absolutely inadmissible to use only a few fen or 1 qian.

Someone asked: "Shengma can stop epistaxis (nosebleed). Why did you omit discussing this? Is Master Zhang Zhongjing incorrect?" I replied: "To regard Shengma as a hemostatic herb is to misunderstand the reason Master Zhang Zhongjing used Shengma. Hematemesis originates from the Stomach, while epistaxis originates from the Lung. To stop bleeding, one must use Dihuang (Radix Rehmanniae); Shengma cannot stop bleeding directly. The use of Shengma here is merely to guide Dihuang into the Lung and Stomach. For such diseases, Shengma should be avoided in large doses; using only a few fen is sufficient to assist and achieve success. It must not exceed 1 qian."

Another question arose: "Shengma ascends but does not descend. Why is an ascending method used for constipation, specifically choosing Shengma? Could Chai Hu not substitute it?" I replied: "Shengma and Chai Hu are both ascending herbs, but one ascends Qi and the other ascends Blood. Dryness and urgency in defecation is due to Fire in the Large Intestine Meridian. Fire in the Large Intestine stems from the depletion of Kidney Water. To moisten the Large Intestine, there is no way other than using Blood-nourishing herbs, and nourishing Blood requires tonifying the Kidney, so that the Qi of the Kidney communicates with the Large Intestine, resolving the obstruction. Thus, generating Blood by unblocking Kidney Qi is feasible. However, the reason for adding Shengma among Kidney-tonifying and Blood-nourishing herbs is that the nature of Yin is stagnant and not prone to flow. By using Shengma to ascend and lift the Yin Qi, the purifying and descending function of Metal (Lung) can be executed. Moreover, the Large Intestine and Lung are exterior-interior partners; when Lung Qi is unblocked, Large Intestine Qi is also unblocked; when Lung Qi is unblocked, Kidney Qi becomes even more unblocked. Therefore, obstructions cease to be obstructed, and knots cease to be knotted. If Chai Hu were used, although it enters the Liver and can elevate Qi in the Blood level, it ultimately cannot enter the Large Intestine or communicate with the Qi of the Lung and Kidney. This is why Chai Hu cannot substitute Shengma." (Comment: The explanation is subtle and divine.)

Someone asked: "Shengma and Xijiao (Cornu Rhinocerotis) are vastly different. Why do ancient texts say that if Xijiao is unavailable, Shengma can be used as a substitute? Is it because both belong to the Yangming Meridian?" I replied: "Although Shengma and Xijiao both belong to the Yangming, Master Zhang Zhongjing used Shengma to substitute Xijiao not merely because they share the same meridian. Xijiao Dihuang Tang treats Fire in the Lung Meridian. Xijiao guides Dihuang to the Lung, and Shengma can also guide Dihuang to the Lung. Since the Lung and Large Intestine are exterior-interior partners, clearing Lung Heat causes the Fire of the Yangming in the Large Intestine to naturally subside, and stasis will exit through the stool. Thus, Shengma clearing the Lung is precisely how it clears Yangming."

Someone asked: "When Shengma is used in Buzhong Yiqi Tang, is it because we fear Chai Hu cannot sufficiently raise the Qi, so we use it as an assistant?" I replied: "In Buzhong Yiqi Tang, where Chai Hu and Shengma are used together, each ascends its respective Qi. They do not interfere with each other but mutually benefit each other. Chai Hu ascends Qi from the left, and Shengma lifts Qi from the right, as stated by the ancients. However, while Chai Hu ascends Qi from the left, it does not fail to lift Qi on the right; while Shengma lifts Qi from the right, it does not fail to ascend Qi on the left. Thus, they mutually attend to each other and mutually benefit each other."